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{In no situation do we ever recommend that fertility diagnosis or treatment be undertaken without the oversight of a qualified medical practitioner. Please use the enclosed information as quick reference and for discussion aids with your practitioner.}

While the term "shooting blanks" can strike humiliation in the hearts of most men, there is much more to male-factor infertility than a matter of azoospermia (absence of sperm).

Various Conditions

Some of the male conditions that may be responsible for infertility are:

• varicocele, a very common cause; basically a varicose vein in the scrotal region
• blockages or obstructions of male reproductive tract, creating oligospermia (low sperm count) or azoospermia (zero sperm count)
• congenital absence of the vas deferens, rendering sperm incapable of traveling to their intended destination; sometimes related to being a healthy carrier of cystic fibrosis disease
• non-obstructive azoospermia, in which blockage is not to blame; may be a result of the male missing part of the Y chromosome
• altered sex steroid metabolism
• adrenal tumors and pituitary adenomas
• Young's syndrome
• Kartagener's syndrome
• Klinefelter's syndrome or other genetic conditions

Diagnosis

Since male factors account for approximately half of diagnosed cases of infertility, it is important that the male partner be just as involved in the diagnostic process as the female. It is not possible for a man to be aware of some of the above conditions without appropriate, skilled examination.

Be prepared to give a thorough personal health and sexual activity history to your medical team. Diagnostic tests may include:

• semen analysis; simple, but embarassing, to perform, this should be the first test administered to a couple
• physical examination, including visual and manual exam
• endocrine evaluation, performed via blood draws
• testis biopsy; less common, only in specific cases

Treatment

Fortunately, treatment for most male-factor conditions is available. Depending on the diagnosis, the options are:

• In vitro fertilization (IVF)
• Intracytoplasmic sperm injection (ICSI)
• Electroejaculation
• Several methods of sperm retrieval, both surgical and needle-aspiration
• Medical therapy
• Vasectomy reversal
• Donor sperm use